高白细胞性白血病的生物学特性研究

Biological Characteristics of Hyperleukocytic Acute Leukemia

本研究探讨高白细胞性白血病(HAL)的生物学特点及其临床意义。采用CD45/SSC双参数散点图设门,应用三色流式细胞术,对48例HAL患者及73例NHAL患者骨髓标本进行免疫分型,并对其中74例进行核型分析。结果表明:HAL组骨髓象中红系比例明显低于NHAL组,差异具统计学显著意义(P<0.05);AML中HAL组CD14阳性率明显高于NHAL组,差异具统计学显著意义(P<0.05);ALL中HAL组CD8阳性率明显高于NHAL组,而CD22,cCD79a明显低于NHAL组,差异具统计学显著意义(P<0.05);HAL组与NHAL组在系列抗原专一表达及交叉表达上无统计学差异(P>0.05);HAL缓解率低于NHAL。结论:HAL比NHAL骨髓受抑程度更重,AML中单核细胞性白血病发生高白细胞性白血病的可能性高,ALL中HAL比NHAL更易于表达T系抗原,HAL的白血病细胞较NHAL处于更早分化阶段,同时HAL预后不佳。

The study was to investigate the biological characteristics of hyperleucocyte acute leukemia （HAL） and its clinical significance. Immunophenotyping was performed in 48 HAL patients and 73 NHAL patients by three-color flow cytometry analysis using CD45/SSC gating, meanwhile the cytogenetic analysis was performed in 74 patients. The results showed that as compared with NHAL group, HAL group had lower proportion of eryth-lineage in bone marrow （P 〈0. 05 ） ; in AML, the CD14 expression of HAL group was apparently higher than that of NHAL group （P 〈 0. 05） ; in ALL, HAL group had higher expression of CD8 and lower expression of CD22, cCD79a compared with NHAL group （P 〈 0. 05） ; the two groups had no significant difference in expression of special lineage antigens and overlapping lineage antigens （ P 〉0.05 ）. The CR rate of HAL group was lower than that of NHAL group. It is concluded that bone marrow inhibition of HAL group is more severe than that of NHAL group. In AML, monocytic leukemia is easier to become into HAL than other leukemias. In ALL, T-lineage antigens of HAL group are more easily expressed than those of NHAL group; the leu- kemia cells of HAL group are naiver than those of NHAL group, meanwhile the prognosis of HAL is poor.